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Hepatitis E in Italy

Hepatitis E in Italy . Site: Institute of Virology, University of Milan Period: January 1994 – December 2001 Study population: 310 patients with acute nAnC hepatitis (negativity for IgM anti-HAV, HBsAg, IgM anti-HBc, anti-HCV, HCV-RNA

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Hepatitis E in Italy

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  1. Hepatitis E in Italy Site: Institute of Virology, University of Milan Period: January 1994 – December 2001 Study population: 310 patients with acute nAnC hepatitis (negativity for IgM anti-HAV, HBsAg, IgM anti-HBc, anti-HCV, HCV-RNA and exclusion of autoimmunity, alchol or hepatotoxic drugs) ALT at the hospitalization: mean 1451.3 IU/ml median 1100 IU/ml range 101-12290 IU/ml

  2. SAMPLES AND METHODS Samples examined: at least two sera collected during the acute and convalescent phase of the illness and stools. Anti-HEV IgG: EIA (Abbott Labs) Anti-HEV IgM:in house EIA HEV RNA: nested RT-PCR ORF3 ORF1 nt 55 nt 320 ORF2

  3. Acute hepatitis E: definition • Hepatitis E was defined by the presence of HEV-RNA • in sera and/or stools; positivity for IgM anti-HEV • and/or seroconversion to IgG anti-HEV. • To identify the risk factors for hepatitis during the • 6m preceeding the onset of the illness, each patient • was interviewed with a pre-coded questionnaire.

  4. Hepatitis E in Italy: Results (1) 44/310 (14.2%) patients with acute hepatits E mean age 29.7, range 3 - 65 years 36 males, 8 females Risk factors: Unknown 2.3% Contact with an infected person 20.4% Travel to: 77.3% India Pakistan Bangladesh Marocco Somalia Angola Sri Lanka

  5. Hepatitis E in Italy: Results (2) PAKISTAN BANGLADESH BANGLADESH INDIA BANGLADESH I2 PAKISTAN B2 Group I B1 INDIA BANGLADESH PAKISTAN BANGLADESH INDIA Group III INDIA US2 C4 INDIA Italia1 US1 C1 C2 C3 Pak1 I1 swUS1 Phylogenetic tree (unrooted) of 14 viral strains from patients with acute hepatitis E Group II Group IV Ct1 Mx1

  6. Hepatitis E in Italy: conclusions • HEV is the aetiological cause in approx 14% of • patients with acute nAnC hepatitis, 95% • exhibiting a benign course. • Hepatitis E is generally diagnosed in travellers • from endemic areas. • The identification of a new variant in an • individual who never indicated travel or contact • with individuals associated with endemic areas, • suggest that this virus may be native to Italy.

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